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13740 UDEN DR
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service
FOIIndatinn Water Line Ceiling 91umhlumb.
Post/Beam Mach, Shear/Sheath Framing -Mach.
Plbg.Und/Flr/Slab Plbg, Top Out Insulation _E
Post/Beam
Beam Struct. Mach, Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: — A M �^P.M. Ent► :
Address: __L3 3 ?,To _^, f
Tenant: Ste: ---MST-
=
Con/(q:
BUP:
�-- (i — MEC: -
` O PLM:ELC-
---
THE FOL NG CORRECT NS ARE REQUIRED: ELR
,
Inspector: - Date: '/�
D DISAPPROVED/CALL FOR REINSP CF C
ERT IVI CATE OF'
OCCUA
CITY' OFTIGARD PLRM I iG #. . . . .P. . ;NCY PIS195- 034 .
COMMUNI TY DEVELOPMENT DEPARTMENT DATE IS5ULD. 07/,6/9b
13125 SW Hell Blvd,Tigard,Oregon 97223,P199 (503)639-4171
PARLIA.. r.,S1041lA- A6,.,,0k1
1, fL wAUDRL— 1,�740 :)W LlUr-�q DR
JE-0 J V I E`i I ON. CAS 7 L.I. F 1.1 L.L NO, Ji PD
. . . . . . . . . .
Of WOW,. :NLW
J-1L OF USE. . . t GF
of..'CUPPNCY URP. :5N
1)(A."UVIANLY LUALIlte
-mat,ksi Fath I
)N 110PRIE53ETIL HOMES, IML.
100 .-,W 144.W)OWS, IN ..
!#KL OSWEGO OR 9'1035
,oviv #: "S03-•-6,i!0...; 536
'lity-actore
, IN MOR151XI7L_ HOME5
)00 '.;W MEADOW) 101)
11 IL 151
041(L 0SWF..(i(J OP 1410,315
Phone #.
Req #. . 1 3,5533
Cer-t -ificate yraints occ-Aiparicv of the above v-efet- eri(-:ecJ bu:tiding or fret tion
her-put and confirms that the buildinU has L)eeri inspec-,ted for c.ompjjanize wii ,
SA iq t p of th"t-gon Specialty %lodet: for the yl-cmpll oc(.uparILY, art-4 use under
the referpnced ptjt-mic was issued.
DI-1.11-1_)ING INS4-'V] 1O11 DOILDING UFFICIA1.
'CIC;T' IN CONSPILLJOU15 PLACE
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 539-4175 Business Phone: 6394171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Fost/Beam gtruct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Bea, San. Sewer Gas Line -Bldg.
Plbg. Unoerho._ Rain Drain Framing Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wali Gyp. Bd. - 7771
Date Requested: ` 9 � Time: AM PM
Address: j 7 &
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
J 42
Inspector:
,APPROVED —APPROVED SUBJECT TO ABOVE
all For Reinsp.
1
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Carer/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath FramingPAech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect
Post/Beam Struct. Mech. Rough-in Gyp. Bd. dy
San. Sewer Gas Line X.opr/Sdwlk Runs.
Other: _.
Date: lC q�: M. —__P.M.- -- E,itry -- — ---
Address: -
�� I
Tenant: - ---- Ste _ MST
Con/Owi; BUP:: ---- - MEC:_.- —
FILM:
ELC:
THE FOLLOWING CORRECTION,ARE RE IIR D ELR:
-N- -P
----------
Inspector: Dater
PPROVED —DISAPPROVED/CALL FOR REINSP. CF CO
- - —
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT -
13125 SW Hall Blvd.,Tigarrd,OR 97223 (503)639.4171 RESTRICTED C-NFA R G Y
PERMIT #: EL R96-0398
DATE Jr•c-"1!ED: 12/31/96
PARCEL..: 2'51 O4 BA--16-100
1 rl (aDDRi_SS. . . : 1374171 SW LIDFtJ DR
IBD IVISION. . . . : CASTLE HILI_ NO. 3 ZONING: R--i.2 PD
'L_OC:;. . .. . . . . . . . LOT. . . . . . . . . . . . . : � a
Pr-0jec-t Descr-iption : INSTALL BURGLAR ALARM
A. RE S I DC-:NT I AL------------ B.
AUD T O 8 S'TERE'O'. . . : riu-t I O 8� S-rEPEO. . : INTERCOM 9 I SAG I NIr .
BURGLAR ALARM. . . . : X BOILER. . . . . . . . . . : I.-ANDSCAPE/IRR?GAT. . :
GARAGC OPFNFP. . . . - CLOr!'. . . . . . . . . . . . MEDTCAI_.. . . . . . . . . .. . .. .
HVAC. . . . . . . . . . . . . . DnTA/TELE COMM. . . NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALAITM. . . . . . : O11'rDOOR L..ANDSC LITE.
OTHER: . . MVAC. . . . . . . . . . . . . PROTECTIVE SIGNAL. . :
T NISTRUMENTAT TON. : n THE:R. . :
TOTAL # OF SYSTEMS: +t)
Owner- : -.__.._..__.___.._ ._-.._.___.____._____.__.___.__.__._______....._._.__._------._.._.., FEES
XIN MORISSETTF SLDRS INC type amount by date recpt
5000 !3W MEADOWS PRMT $ 40. 00 TAT 1.2/31./9(7, 96-2882.99
LAKE OSWC(30 OR 9703 5PCT $ 2'. 00 TAT 1.2131/96 96-1-188299
71In o n e #: 620-753S
BRINKS HOME: SECURITY $ 42- 00 TOTAL.
1307-59 SW CIRRUS DR
------ RE OU I RED I N`;PECT I nNS -_-_-
CkEAVERTON OR 97009 Ceiling Cove- Elect, ] Service
Phone #: V--641---0574 Wall. Cover Elect' l Fi.nal
Peg #. . . 444F='l
This permit is issued subject to the regulations contained in the �� -) / /
Tigard Municipal Code, State of Ore, Specialty Codes and all other PP r m t e
applicable laws. All wor4 will be done in accordance with
approved plans. This pereit will expire if work is not started /
within 188 days of issuance, or if work is suspen ed for more L. —
I
than 188 day'. INSrAI_.LATION ONLY-
The installation is being made on property I own which is not intender] for
sale, lease, or rent.
nWNER' r SIGNATURE: _ _ DATE: T
____. ................... . ..._.____._..._._----..-_COtdTRACTOR INSTAI_.L.ATTON
c7I GNATURE OF SUPR. ELEC' N: DATE c
' TCENSE. NO:
Ca I for inspection — G39--.41.75
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard,OR 97223 PERMIT#
Phone(503)639-4171
FAX(503)684-7297 DATF ISSUED_ 12 J
TDD No. (503)684-2772 —
CITY OF TIGARD Inspection (.503) 639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INS ALLATIO 4. TYPE OF WORK
1 �c
Jjr(lss V
RESIDENTIAL—Restricted Enemy Fee . . 540.00
(FOR ALI. SYSTEMS)
City State Lip deck Type of Work Involved:
PFRMITS ARE NON-TRANS'FRABLE AND NON-REFUNDABLE AND EXPIRE IF WORK
IS NOT STARTED WITHIN 1,x DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR ❑ Audio and Stereo Systcros
180 DAYS. Burglar Alarm
2. CONTRACTOR APPI.ICATI/JN Garage Doer Opener*
Contracto
liRINKS HOME SECURLTt ALARM El Heating,Ventilation and Air Conditioning System*
i_ type_____ ❑ Vacuum systems*
Address 8059 S.W. CIRRUS DRIVE, BEAVERTON 97008 ❑ Other -- - --- ---
Date"/ 1� ---_ _ COMMFRCIAL—Fee for each system . . . . . . . �40.p0
' –� (SEE OAR 918-260-260)
Property Owner /
– Check Type of Work InYvlv_efl;
Contractor's Board Reg. No. _ 044411 _ ❑ Audio and Stereo Systems
El Boiler Controls
Phone# _ (503) 641-0574 ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fiw Alarm Installation
----- IJ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control'
City State Zip ❑ Medical
This permit is Issued under OAR 918-320.370.This applicant agrees to make only ❑ Nurse Calls
restricted energy installations(too volt amps or less)under this permit and to do the ❑ Outdoor landscape Lighting*
following:
1. Only use electrical licensed persons to do installations where required.(Certain ❑ Protective Signaling
residential and other transactions are exempt from licensing.These have ❑ Other
asterisks(•).All others need licensing). ----- —
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503.639-4175.
❑ Number of;ystems
3. Purchase separate permits for all Installations that are not ready for inspersion
whrn the inspector Is out to Inspect under this permit. •No licenses are required. Licenses are mqulrec for all other Installations.
4. Assume responsibility for assuring that all corrections required by the Inspector
are done,and -- ----
5. Assume responsibility for calling for a final inspection when all of the 5. FEES
corrections are completed.
The person signing for this permit must be the applicant or a person a. Enter Fees $ 0
authorized to bind the applicant. ---7-- -
b. .5% Surcharge (05 x total ahnve) $___ :;4
Signahircr
TOTAL $z�
Authority her than applican
ENI F'(;,^,I'r I II`
MSER
CIT` OF TICARD PERMIAT T#. . . . . . . :PERMIT MST95--0368
COMMUNE rY DEVELOPMENT DEPARTMNT DATE ISSUED: 10/16/95
13125 SW Hall Blvd.Tigard,Oregon 97223e8199 (603)639-4171
r--,ARCEI-.: 2SI04BA-CH3193
SITE ADDRESS. . . : 13740 SW LIDEN DR
SUBDIVISION. . . . - CASTLE HILL NO. 3 ZONING- R-12 PD
BLOCK. . . . . . . . . LOT. . . . . . . . . . . . . .. 193
BUILDING
REISSUE: DWELLING UNTTS: 1 BASEMENT. . . . . . . . :0 sF
CLASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . :480 Sf
TYPE OF USE. . . :GF FLOOR AREAS- REQUIRED SETBACKS-
TYPE OF CONST. s5N FIRST. . . . : 1086 Sf LEFT. . -5 ft RIGHT. i5 ft
OCCUPANCY GRP. tR3 SECOND. . . : 1360 Sf FRONT. :~0 ft REAR. . t15 ft
STORIES. . . . . . . s2 FINSSMENT:121 sf REQUIRED-- ---____.___-_____._
HEIGHT
EQUIRED----------------------
HEIGHT. . . . . . . . :28 ft TOTAL------:2446 SF SMOKE DETECTOPS. :Y
FLOOR LOAD. . . . 140 Psf VALUE. . . . . '< : 165968 PARKING SPACES. . :2
Remarks : Path I
PLUMBING
SINKS. . . . . . . . . . : 1. FLOnR DRAINS. . . . 10 DACKFLOW PREVNTRG. . : 1
LAVATORIEc;. . . . . :4 WATER HEATERS. . . - I TriAr-s. . . . . . . . . . . . . . :0
TUB/SHOWER3. . . . 13 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :O
WATER CLOSETS. . :3 SEWER LINE (ft ) . :27 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : I Wr)TEP IINE (ft ) . z27 OTI4ER FIXTURES. . . . . .0
GARBAGE D!SP. . . l; 1 RAIN DRAIN (ft ) . :O
WASHING MACH— : 1 SF RAIN DRAINS. . : 1
MECHANICAL FEES
FUEL TYPE'S------------ UNIT HTR S. . -0 type amoi-int by date r,ec-pt
/GAS/ VENTS TIF $ 1590. 00 JDA 10/16/95 95--C.'71695
MAX 1NPUT:0 BTU VENT FANS. . :=:J.' SWm $ 100. 00 .JDA I Vol I E./95 95-271695
FURN ( 100K . . - I HOODS. . . . . . : 1 BPRT $ 598. 00 JDA 10/16/95 95--271695
TURN ) =11210K . . :0 WOODSTOVES. :0 SPLC $ 388. 70 95-269728
FLOOR TURN. . . . :0 CLO DRYERS. : I B5PC $ 29. 90 JDA 10/16/95 95--271695
BOIL/CMP ( 3HP:O OTHER UNITS:0 PARK $ 500. 00 JDA 10/16/95 95- 271,605
GAS OUTLETS 41 MPRT $ 33. 00 JDA 10/16/95 95-271695
Owners: ------- $ 8. .=5 JDA 10/16/95 95-271695
DON MORRIESETTE HOMES, INC. 115PC $ 1. 65 JDA 10/16/95 95-271695
woo sw MEADOW[:-,, INC. 3STH 11- 225. 00 JDA 10/16/95 95--271695
FPLC $ 47. 55 JDA 10/16/95 9!!-271695
LAKIE OSWEGO OR 97035 P5PC $ 9. 51 JDA 10/16/95 95-271695
Phone #: 503-620-7538 EROS $ 64. 00 JDA 10/16/95 95-271695
Contr-actoy— 1 1.*:.0. 80 JDA 10/16/95 95-1:271695
DON MORISSETTE HOMES E RPC $ :'0. 80 JDA 10/16/95 95-i?74
5000 13W MEADOWS RD
SUITE 151
LAKE OSWEGO OR 97035
Phone #ll 620-7538
Reg #. . : 35533
36 37. 16 TOTAL
mi., art-mit is issued subject to the regulations contained in the REQUIRED INSPECTIONS
Tigard Municipa! Code, State of Ore. Specialty Codes and all other Footing Insp Pl,_tmb Top put
applicable laws. A;l work will be done in accordance with approved Fo�tndation Insp Electv-ical Set,vi
plans. This permit will expire if work is not started within IN Post/Beam Sitt'Llct Electr-ical Rough
days of issuance, or if work is .suspended for more than 180 days. Post/Beam Meehan Framing Insp
Cr-awl Drain Low Voltaqe
.. .....wk_k�(_ Plm/lindslab Insp Fire lace Insp
PILM/Undet-floot, Gas Line Insp
s 5 Ued BV ; tylechanic-al. Insp InSmIation Inst
Call for inspection 639-4175
PERMIT
CITY OF TIQA, •
. . . SWR95-04J`4
, RD DATEIISSUED: . 10/16/95
COMMUNITY DEVELOPMEN r' DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PARCEL: 2SI04BA-10100
S I TE A D D R G. . . - 13 i 110 3 W L I L,I--.i'•1 1)k
SUBDIVISION. . . . : CASTLE HILL ZONING: R--12
BLOCK. . . . . . . . . . : LOT.
TENANT NAME. . . . . :DON MORRISETTE
USA NO. . . . . . . . . . :I FIXTURE UNITS. . . - 16
CLASS OF WORK. . . :NEW DWELL.I NO UN I TS. . - J
TYPE OF' USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYP,'7-. . . . tBUSWR IMPERV SURFACE. . : sf
Remarks : ConStir-LICt single family dwelling
Owner: FEES -
DON MORRIESETT17 HOMES, INC. type amoLint by date t-ecpt
5000 qw MF.(4I)()WG, INC. PRMT $ 2200. 00 JDA 10/16/95 95--I-R'71695
INSP $ 35. 00 JDA 10/16/93 95-271695
I-AKE OSWEGO OR 97035
Phone #z 503-620-7538
Cotitt-actor—
CONTRACTOR NOT ON FILE
F-1-inne $ 2L35. 00 TOTAL
Rey #. . :
REOUIRED INSPECTIONS
This Applicant aprees to comply with all the rules and regulation, Sewer• Inspection
of the Unified itbiage Agency. The permit expires 189 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the seoer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. if not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
Permittee SignatLa-e '.
By
C a 11 n s p e c-t J.on 639--4175
City of Tigard Residential BuildinPermit Application
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
Office Use Only
Subdivision: Lot #
Planck/Rec #
Valuation: _ _
Corner Lot? Y N Permit
Reissue of
Flag Lot? Y N - --
Map & TL#
Owner: DOtJ V-'10Ic I SGerE t �0 -iJ�
Approvals Required
Address: CM D3NfJ Planning _.t. )--`-�� ( �� �K
� -
Q5AAZA0 OX 225L Engineering
Phone s fir_ _ Other
Contractor: 141"1E r�� _ 1/ _ _—. Items Required
Address. —_ _ -- Subcontractors
-- --------- — Truss Details
Phone: 2-� Other _
Contractor's License
(attach copy of current Oregon license)
Contact Name & Phone: (�� — (.nib' X738
Subcontractors: Arch itect/Engineer:�]
Plumbing.,t��UEJ:-1Prftl�2 }�.UH jj I NJ(a Address:J_.)G(Y ,tN
Mechanical:-DQ (0UI`R4--1 _!� P- Uoni E __qio-35
(attach copy of current OR Contractor's License) p,
Phone: _tfloQ_
JOB DESCRIPTION c
IJ
Applicant Signature & Phone number
Received bv: _� _— --_ — gate Received:
N MOPOTOMMARESAPP
Permit # Account Description Amount Amt. Pd. Bal. Duo
i
Bldg. Permit (BUILD) LJ V, - '
Plumb. Permit (PLUMB) __ ���• J�
_ Mech. Permit (MECH)
State Tax (TAX) _ ('jJ
Bldg: �n yU .
Plumb:
Mech.
'"Ilan Check (RbC1E) �( �'I`� 3S.�v SSU "J r7b
: 1'(�.I► I�L� _ _� 5�
Plumb
Mech:
Sewer Connection (SWUSr1)
(J v
Sewer Inspection (SWINSP) 3S.
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL) _ _ ALTO,
SOU.
Water Quantity (WQUANT) *W_
Fire District (FIRE) _ _ 4,ywJ
Erosion Cntrl Permit (ERPRMT) _ _ 1 06
Erosion PlanciIUSA (ERPLAN)
Erosion Planck,'COT (EROSN)
6, 22,
TOTALS: S ,� I
S
FF1-11 :FIRST R ER1CF-J TFI4--"C_,SF;N It-1 5036�D7yJ lrly5.09OR-:Oz ti679 P.03,,0-4
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.`,•.':ti; .rte� .
r'
Credit No: tii;w:;,:
Date !:sued:
Ari i.TWFIC IMPACT FEE
? ; CREDIT VOUCNE,7
In acacrdarres with the Trac Impact Fee Ordlnares, Matrix Dev9lopment Cornoraticr,
A; is entitled:o 4i r o, !n Traffic lmpact FOR Credits that can ba epplisd to 17 Charges
;;, an I'Ot(s)Ea-J31 of tt'a Castle P'illl No. Development. i'Drr usi of T/FCredlts ••
&I sublet:tc the rules and limiletions cf the r1F Ordlrance. WAr?N1NG: ►r•
^z«. "4's Voucher must ba ^resented At Lha time of issuarrca o: ,,he ELfiding Permit or if deferral
was :anlad Issue ice of '
S err Oc upgncl rerrrmiL
�:: .rrfi :tit
MAi r ih CE VZ-OFMENT CORPORA TION hRraby assigns a!/its right,
title 217d hVO,' s:in and to thet CV14 Trzr-,'i ! ti
' c moect F,te Credit to�e gr�rt�d «.-:,;•,
W upcn the Issuance of a bullc"na Qermlt for Lot 1q -3
i �• ' CAST Lr HILL NC. 2 sL:dlvlsicn, Washln;tor Caunrr, Gr2gcn, to the order o` N'
This assr'�•17m9rl cf T rat`'ic lr7pect Fpr Credit is eat a and given
day of I S: -
';••4'. MA TrJ!.0 D0V-E LOFM,EtVT CCRPCRA TION,
srr Crr;on Corporation
T
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F :`''�' j� i` % •S'Jft r'. t�� s%7 y�;r, r t S y, t,;l 1'�
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�!. � •qac' �• t!qr.� •`1 V• '•�;�!•.•t' ,\•.� •!'r,::.•
1 6000 B.W.Meadows Rd.,Ste.161
Lake Oswego,OR 87035
Phone:(603)620-7658
E. I1 - �0�rO11 FAX:(603)620-7485
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Community Development ELECTRICAL_ PERMIT APPLICATION
13125 SW Hall Blvd. _
Tigard, 0R 97223 PlancVJRec. V 95 7�.2cy
Permit # s--- og96,
Phone (503) 639-4171 Date Issued r,o - A 7-4.5
CITY OF TIGARD FAX (503) 684-7297 Issued by
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: ^ 4. Complete Fee Schedule Below:
Name of Development C�-/_ // Number of Inspections per permit allowed
Address / y/� .5/A� �C-t�C h Service includad Items Cost(ea) Sum
r
City/State/Zip I la C it 722 3 4s. Residential-per unit °
`--7 r000 sq it or leas $11000
jEach admional 500 eq It or
Name (or name of business),jo j Ij1ii rsk: e- l .'�'1r portion thereof $2500 —25— '
Commercial❑ Residential% Each
Limited Energy $2500 2
Each Manul'd Homw or Modular
Dwelling Service or Feeder $6800
2.a. Contractor installation only: 4b.Services or Feeders
Installation Alteration or ralor:ation 2
Electrical Contractor 200 amps or leas 56000 2
Address_�n?D S4� amps
amps to 400 amps 00 _ 2
401 amps to 600 5120120UO 2
Cily & nVU tv 1r3 State_ __ Zip 4 gpLLE 6n1 amps 10 1000 amps -- $18000 2
Phone No. (0 4 1--fav 12-- over 1000 ampe or volts $34000 2
Contractor's License No._ L I'; _— neconnecl only $5000
Contractor's Board Reg. No. 0L Z— 4c. Temporary Services or Feeders
/ Installation alteration or relocation 2
c�. ��— 200 amps or less $50 00 2
Signature of Supr. Elec' Phone No.b
License No. 3S�`j y/-POt2, 201 amps to 400 amps :000 2
.T., 401 amps to 000 amps $100000
Over 600 amps to 1000 volts
2b. For owner installations: alis,V above
4d. Br-nch Circuits
Print Owner's Name_____ _.___ New rio-ahon or edens•jn per panel
Address a)1he fee for branch circuits with
purchase of sarvka or faader tea. 2
City_ — State_ 71p Each branch circuit $500
Phone No. h)The lea for branch circuits wtfhoul
The installation is being made on property I own which is purchase of sorvke or faadsr fes. 2
First branch circuit $3500 _
not intended for sale, lease or rent Each additional branch circuit ^_ $500
Owner's Signature- _.. 4e. Miscellaneous
(Service or feeder not Included) 2
3. Plan Review section (if required): Each pump or irrigation circle $4000
Each sign or outline lighting $4000
Signal circuit(s)or a limited energy 2
Please check appropriate item and enter tee in section 58. panel alteration or edensron $40 UO
4 or more residential units in one structure Minor I_ahals(10) 510000
Service and feeder 225 amps or more
{� System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
�— as described in N E C Chapter 5 Per Pen hour hour ion $35 00
E55 00
In Plant $55 00
Submit 2 sole of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees: � l
NOTICE
Sa. Enter total of above fees
5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS Al ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust Account 8 $
Balance Due $
«,«tr..nd.e.wcnm am
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
JARDINE PLUMBING
P 0 BOX 186
ESTACADA OR 97023
Plumbing Signature Form
Permit #• . . . : NOT95-0368
Date Issued. : 10/16/96
Parcel. . . . . . : 28104BA-16300
Site Address: 13740 8W LIDEN DR
Subdivision. : CASTLE HILL NO.3
Block. . . . . . . . Lot: 193
Zoning. . . . . . . R-12 PD
Remark:
Path I
Your company has been indicated as the plumbing contractor for the permit indica
for the plumbing permit to be valid, please have the appropriate individual from
below and return this Plumbing Signature Form prior to the start of work. No pl
will be authorized until this completed form is received.
AN INR SIGNATURE IS REQUIRED ON THIS FOR)!
OWNER: PLUMBING CONTRACTOR:
DON MORRIESETTR HOMES, INC. JARDINE PLUMBING
5000 8W MEADOWS, INC. P 0 BOX 186
LAKE OSWEGO OR 97035 ESTACADA OR 97023
Phone #: 503 -620-7538 Phone #:
Reg #. . : 108747 --�
Signature of Authorized Plumber
Please return this completed form to the address above.
ATTN: Building Dept.
cz--r t,YL.0 T ryc ..._..r
If you have an_ questions, please call 639-4171, ext. 0310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
TRI-COUNTY TEMP CONTROL
13651 BE AMBLER RD
CLACKAMAS OR 97015
Electrical Signature Form
Permit #. . . . : NOT95-0368
Date lssued. : 11/15/96
Parcel. . . . . . : 28104BA-16300
Site Address: 13740 SW LIDEN DR
Subdivision. : CASTLE HILL NO.3
Block. . . . . . . . Lot: 193
Zoning. . . . . . . R-12 PD
Remarks:
Path I
Your company has been indicated as the electrical contractor for the permit indi
order for the electrical permit to be valid, the signature of the supervising el
is required.
Please have the appropriate individual from your company sign below and return t
Signature Form prior to the start of work. No electrical inspections will be au
th .s completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: ELECTRICAL CONTRACTOR:
DON MORRIESETTE HOMES, INC. TRI-COUNTY TEMP CONTROL
5000 SW MEADOWS, INC. 13651 BE AMBLER RD
LAKE OSWEGO OR 97035 CLACKA14AS OR 97015
Phone #: 503-620--7538 Phone #: 654-3115
Reg #. . : 72623 )
1 '
Signature of Supervising 9l�ectri lac
Please return this -:ompleted form to the address above. j
ATTN: Building Dept. L/
if you have any questions, please call 639-4171, ext. #310